X12 Ingest & Denial Analytics

Demo Environment โ€” Synthetic Data OnlyThis application contains synthetic demonstration data only. Do not enter or submit patient information (PHI) or other sensitive personal information.
Members›policy B05M000005›KEVIN HUGHES

KEVIN HUGHES

Subscriber on policy B05M000005

Claims
1
Attributed to this person
Charged
865.00
Total submitted
Denied
865.00
1 denied claims
Patient responsibility
0.00
Reported on the 835

Patient responsibility is the amount reported on the 835 as assigned to the patient โ€” deductible, coinsurance or copay. It is not proof that the provider billed the member, that the member owes it, or that it was collected, and it is kept separate from denied amounts throughout.

Who this is

FieldValue
NameKEVIN HUGHES
Role on the policySubscriber
PolicyB05M000005
Date of birth19 Jan 1967
PlanPLATINUM PPO
Covered from8 May 2024
Covered toopen

Patient responsibility reported on the 835

No patient responsibility reported on this person's remittances.

Care and denials

ClaimServiceChargedPayerOutcomeDenied
CLM000002310 May 2024865.00MERIDIAN HEALTH PLANCARC 27 ยท ELIGIBILITY865.00